Provider Demographics
NPI:1275505992
Name:ANTON, REIN (MD)
Entity Type:Individual
Prefix:DR
First Name:REIN
Middle Name:
Last Name:ANTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 E ELVIRA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-7124
Mailing Address - Country:US
Mailing Address - Phone:520-874-4024
Mailing Address - Fax:
Practice Address - Street 1:2701 E ELVIRA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-7124
Practice Address - Country:US
Practice Address - Phone:520-874-4024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072704L207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA140007954OtherRR MEDICARE PIN
PA0018262660001Medicaid
PACC9269OtherRR MEDICARE GROUP
PA0018262660001Medicaid
G98935Medicare UPIN